Options Care Limited, a small domiciliary care service supporting three people with learning or physical disabilities, was rated Good overall, maintaining its previous 2018 rating across both inspected key questions. The service demonstrated safe, person-centred care with strong leadership, though a minor gap was noted in not consistently exploring employment history gaps during recruitment.
Concerns (1)
minorRecord keeping: “The provider did not always explore gaps in people's employment records and the registered manager told us they would do so going forwards.”
Strengths
· Low staff turnover with consistent, long-serving staff who know people well
· Electronic medicines administration records enabling real-time oversight and audit
· Registered manager completing leadership qualification and maintaining up-to-date training
· Person-centred care respecting equality characteristics, including cultural needs such as hair care preferences
· Robust audit system covering care records, supervision, spot checks, training and service user feedback
Options Care Limited was rated Requires Improvement overall following inspections in December 2016 and January 2017, with breaches of Regulations 17, 18 and 19 identified relating to insufficient staffing, inadequate DBS and recruitment checks, and ineffective governance and record-keeping. Staff were found caring and responsive in practice, but systemic failures in oversight and workforce management posed significant risks to people using the service.
Concerns (6)
criticalStaffing levels: “We found 50 incidences of staff being recorded in two locations at the same time for 10 minutes or longer and this did not take into account any travelling time.”
criticalStaff competency: “When we checked staff files there were no records demonstrating staff had been assessed as competent.”
criticalSafeguarding: “One member of staff, who was a close family member of the registered manager, had been working unsupervised since the beginning of October 2016 without a completed DBS check.”
criticalGovernance: “Although the service did have systems to assess, monitor and improve the quality and safety of services provided, these were not effective in identifying the issues we found.”
moderateStaff training: “Four members of staff had no records of any further training delivered by the service other than the induction training and the Care Certificate.”
moderateRecord keeping: “The provider did not ensure records relating to the provision of the regulated activity were accurate, up to date and fit for purpose.”
Strengths
· People and relatives reported staff were caring, treating people with dignity and respect.
· Risk assessments reflected people's needs and were responsive to changes; medicines were managed safely.
· Care plans were person-centred, using person-centred language and identifying needs, goals and preferences.
· Staff received regular supervision meetings and annual appraisals.
· The service was working within the principles of the Mental Capacity Act.
Quality-Statement breakdown (19)
safe: Staffing levels and deploymentRequires improvement
safe: Recruitment and DBS checksRequires improvement
safe: SafeguardingGood
safe: Risk assessmentsGood
safe: Medicines managementGood
effective: Staff training and inductionRequires improvement
Options Care Limited achieved a Good rating across all five key questions at its September 2018 inspection, having fully remediated three regulatory breaches identified at the previous inspection in 2016–17 relating to governance, fit and proper persons, and staffing levels. The service demonstrated personalised, timely care delivered by well-trained and supervised staff, underpinned by effective quality assurance and strong registered manager leadership.
Strengths
· People received care visits on time and for agreed durations, with electronic call monitoring confirming arrival and departure times.
· Robust recruitment practices including rolling programme, DBS checks, and ongoing DBS status verification at supervision.
· Staff received regular supervision (three times per year), annual appraisals, and role-specific training including the Care Certificate.
· Care plans were personalised, regularly reviewed, and included life histories to enable meaningful staff-person relationships.
· Cultural and spiritual needs were assessed and met, including arranging relative-led training for staff on specific cultural practices.
effective: Mental Capacity Act compliance
Good
effective: Nutrition, hydration and healthcareGood